Under the ACA, a person can choose whether to buy health insurance and which policy to buy through state insurance exchanges, but must pay a penalty for choosing not to buy coverage. A series of ballot measures this November 6 will attempt to change those requirements, rendering the ACA ineffective in the following states:

Alabama: Amendment 6

If passed, this constitutional amendment will prohibit mandatory participation by any person, health-care provider or employer in any health care system. In turn, this would negate the “mandate” for individuals or employers who refuse to buy health insurance under the ACA. This measure is an attempt to block the ACA from taking effect in Alabama.

VOTE: NO

Florida: Amendment 1

Similar to the Alabama measure, the Florida Health Care Amendment aims to prevent laws or rules penalizing any person or employer who chooses not to purchase health care coverage under the ACA.

VOTE: NO

Missouri: State Bill 464

This state bill prohibits the establishment, creation or operation of a state-based health insurance program (required under the ACA) unless initiated by a legislative act, petition or referendum.

The Montana measure (LR 122) would allow state residents to choose whether or not they would like health insurance, without penalties. Should they choose to buy health insurance, residents would be allowed to choose which insurance they buy. If this amendment passes and residents are not penalized for choosing to not to purchase health insurance, the ACA will be blocked from taking effect in Montana.

VOTE: AGAINST

Wyoming: Constitutional Amendment A

The Wyoming Health Care Amendment would prevent any state or federal law from requiring a person, employer or health-care provider to participate in any health-care system. It would therefore prevent the implementation of the ACA or an insurance-exchange program without legislative approval.